The present invention relates to a cannula and a procedure for gallbladder elimination.
The accepted medical practice in resolving gallbladder lithiasis is the complete elimination of the gallbladder and its stones. There are two methods in present usage which achieve that goal:
1) the cholecystectomy (removal of the gallbladder) and PA1 2) the percutaneous radioscopic gallbladder chemical-sclerosis (the gallbladder disappears by means of atrophy).
Cholecystectomy, which is a major, accepted and successful surgical procedure (FIG. 1A), is performed by means of an abdominal incision (a laparotomy) or by means of an abdominal endoscopy (laparoscopy). In both cases, general anesthesia is required. The conventional cholecystectomy, which is used most often, requires general anesthesia because of the need to make an incision in the abdominal wall 2 to remove the gallbladder 3 and close the cystic duct 8 (the exit duct from the gallbladder 3 which communicates between the gallbladder 3 and the main duct 9 which leads to the liver 10). The endoscopic (or laparoscopic) cholecystectomy requires general anesthesia also, as the procedure involves a hypertensive pneumoperitoneum, where the abdomen is insufflated to create a space within which the surgeon can work.
Percutaneous radioscopic gallbladder chemical-sclerosis (FIG. 1B) requires only a minor local anesthesia. The procedure commences with a puncture in the abdominal wall 2 by insertion of a needle (not shown) and then a catheter 24 into the gallbladder 3 while under radioscopic control. Dilatation of the passage created by the catheter 24 is performed in a progressive manner over several days. Retrieval of the gallbladder stones 11 is performed by means of instruments placed through the dilated passage under radioscopic control. Occlusion of the cystic duct 8 (the exit duct from the gallbladder 3 which communicates between the gallbladder and the main duct 9 which leads to the liver 10) is performed by means of electrocoagulation using a monopolar wire or bipolar wires guided under radioscopic control. The scar created by the electrocoagulation procedure requires several days to occlude the cystic duct 8. Ablation of the gallbladder mucous membrane (the inner layer of the gallbladder 3) is then performed by means of chemical liquids injected through a catheter 24 into the gallbladder lumen, in repeated sessions over weeks or months. The percutaneous radioscopic gallbladder chemical-sclerosis procedure removes the bile and stones 11, closes the cystic duct 8, and ablates the gallbladder mucous membrane, inducing a definitive sclero-atrophy until the gallbladder 3 disappears. Although this procedure is mini-invasive and requires only local anesthesia, it is used infrequently in high (surgical) risk patients (in whom it is necessary to avoid general anesthesia) as it has the drawback of requiring multiple sessions over weeks or months to be completed.